Hello, and I hope I can help you today.
First of all, I want to reassure you that your
episiotomy site will heal, but it is just going to take some time.
Getting an infection of your episiotomy site or an obstetric laceration is uncommon, but it can occur just like any other type of surgical wound. When a wound is infected, it actually decreases it's chance of healing on its own if it is sewn closed again because the pus and infected tissue can get trapped under the skin. Letting a wound heal open is called having it heal by secondary intention, and it is the recommended way to treat infected surgical
incisions and wounds anywhere on the body.
Normally, once the infection resolves, the gap between the sides in your vaginal opening will gradually get smaller and fill in with healthy tissue. However, this can even take 6-8 weeks to happen, and I understand that it may look scary right now before healing has taken place.
Taking your antibiotics and anti-inflammatory pain relievers is the correct treatment, and your pain should significantly improve once the infection is gone, but there are some things you can do to ease the pain and promote healing. For one, when you urinate, use a squirt bottle filled with warm water to wash your
perineum (your doctor should be able to provide you with one) so the urine doesn't sting the incision. When you move your bowels, wipe carefully from front to back using moist baby wipes rather than dry tissue. Taking a sitz bath at least daily (twice is better) by dissolving a small amount of baking soda or epsom salts in a shallow tub of warm water and sitting in it for 20 minutes at a time will help soothe the pain as well as keeping the area clean. And trying to keep your legs together and avoid spreading out your labia will help the two sides heal back together more efficiently.
So in summary, your infected episiotomy should heal on it's own but it can even take 2 months to do so. Until then, I recommend you take your antibiotics and pain relievers, avoid any sexual activity or putting anything inside the vagina, and follow up with your doctor regularly to assess the progress of your healing.
I hope I was able to adequately answer your question today and that you feel better soon,
Dr. Brown